Personality disorder and intellectual disability – concept and prevalence
| Published date | 06 July 2015 |
| Pages | 163-173 |
| DOI | https://doi.org/10.1108/AMHID-05-2015-0019 |
| Date | 06 July 2015 |
| Author | Hilde Katrine Andersen |
| Subject Matter | Health & social care,Learning & intellectual disabilities |
Personality disorder and intellectual
disability –concept and prevalence
Hilde Katrine Andersen
Dr Hilde Katrine Andersen is
Specialty Trainee at the
Learning Disabilities,
Leicestershire Partnership
Trust, Leicester Frith Hospital,
Leicester, UK.
Abstract
Purpose –The range of prevalence of personality disorder (PD) found in people with intellectual disability (ID)
has been reported as vast, and has included data from dissimilar settings. The purpose of this paper is to
review the reported prevalence of PD in the general population of people with ID, and to consider how
different and changing ideas about PD have affected these rates.
Design/methodology/approach –Cross-sectional studies of the prevalence of PD in people with ID were
identified. The quality of the studies was considered, along with how cases of PD were identified.
Findings –Six studies were included. The reported prevalence of PD in people known to have ID ranged
from 0.7 to 35 per cent. Possible reasons for this wide range included different views of PD and methods of
assessment.
Research limitations/implications –The wide range of findings suggests that methodological differences
are significant. Consideration to how clinicians should respond to the overlap of impairment between ID and
PD may improve the conceptual clarity of PD, informing future epidemiological research.
Originality/value –This review was limited to studies of samples likely to be representative of the general ID
population. The range of prevalence estimates was narrower than previously reported, and more likely to
reflect the true prevalence rate of PD amongst people who have ID. Consideration was also given to how
different ideas of PD led to different methods and may have contributed to variance in the results.
Keywords Intellectual disability, Classification, Concept, Prevalence, Epidemiology, Personality disorder
Paper type Literature review
Introduction
Intellectual disability (ID) affects approximately 1 per cent of the population, and involves deficits
in everyday adaptive functioning directly related to deficits in intellectual functions with onset
during the developmental period (American Psychiatric Association and DSM-5 Task Force,
2013). Individuals affected will have additional social, educational and health needs depending
on their level of functioning and associated difficulties such as challenging behaviour, mental
disorders and other health problems. The presence of personality disorder (PD) is negatively
associated with quality of life, function (Skodol et al., 2014; Torgersen, 2014) and response to
treatment for some mental illnesses (Skodol et al., 2014; Tyrer et al., 2011). Due to an already
lower level of adaptive functioning, the impact of a PD on an individual with ID may be particularly
significant.
Why knowledge about the prevalence of PD in ID is important
A good estimate of the prevalence of PD in people who have ID could help identify the scale of
additional needs that it results in. Previously, it has been reported to vary to an extreme extent
(Alexander and Cooray, 2003), making it difficult to know the impact that PD in ID has in terms of
suffering, disability, health and additional support needs.
Received 7 May 2015
Revised 14 May 2015
Accepted 14 May 2015
DOI 10.1108/AMHID-05-2015-0019 VOL. 9 NO. 4 2015, pp. 163-173, © Emerald Group Publishing Limited, ISSN 2044-1282
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ADVANCESIN MENTAL HEALTH AND INTELLECTUALD ISABILITIES
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